W-96 (1).pdf

This document is an Internal Revenue Service (IRS) Form W-9 Request for Taxpayer Identification Number and Certification. The form is designed for individuals or entities to provide their taxpayer identification information to requesters who may need to report payments made to the IRS. It includes sections for entering personal/business details, taxpayer identification number (TIN), and a certification section where the individual attests to the accuracy of the information and their U.S. person status.

The form requires the taxpayer to enter their name, business name (if different), federal tax classification, exemption codes, and either a Social Security Number or Employer Identification Number. Part II of the form includes certification statements such as confirming the accuracy of the TIN, acknowledging backup withholding requirements, and declaring U.S. citizenship or U.S. person status. The document provides general instructions about its purpose, which is to provide information to entities that may need to report payments or transactions to the IRS, such as for interest, dividends, and various types of income.